Part of what makes us women is our unique hormonal makeup. The sex hormones, estrogen, progesterone, and testosterone, are the most well-known because of their influence on the reproductive system – from puberty to menopause. But these hormones have important roles to play beyond merely reproduction.

Hormones are natural substances produced in the body. They act as little messengers that allow cells and tissues to communicate so that the body knows how it should be functioning. There are various hormones produced in different areas of the body, like the brain, ovaries, thyroid gland, and the adrenal glands. In addition to the menstrual cycle, hormones also control other aspects of health like energy levels, weight, sleep, and mood. When it comes to hormones, there is a delicate balance. They all serve an important purpose, but when they are dysregulated or become imbalanced, symptoms can arise. Let’s discuss the important roles that the sex hormones play in regards to female health, and what can happen when these hormones become dysregulated.

ESTROGEN

Estrogen is the ultimate female sex hormone. It is responsible for the development of female characteristics like our curves and breasts, and of course, it plays a huge role in regulating the menstrual cycle. But on top of this, estrogen is critical in blood sugar regulation, building a strong immune system, preventing osteoporosis, maintaining heart health, optimizing fertility, brain protection and supporting healthy skin and hair. Women make estrogen in the ovaries for the most part, but smaller amounts are also made in fat tissue and the adrenal glands. When estrogen becomes imbalanced, this is what we see:

TOO MUCH ESTROGEN

This is what we typically refer to as Estrogen Dominance. A state of too much estrogen can be caused by an overload of estrogen, or because there is not enough progesterone to balance out the estrogenic activity. A big contributor to estrogen dominance is exposure to environmental chemicals that mimic estrogen in the body, like plastic and common pollutants. These are called xenoestrogens. 

SYMPTOMS OF ESTROGEN DOMINANCE INCLUDE:

• PMS
• Heavy, painful and/or irregular periods
• Fibroids
• Water retention
• Swollen and tender breasts
• Headaches      
• Weight gain, especially in the tummy and thighs
• Mood swings or irritability

If you have symptoms of estrogen dominance, eliminating excess estrogen is key. This means:

• Promoting daily bowel movements
• Supporting liver health with things like B-vitamins, calcium d-glucarate, detoxifying herbs like milk thistle and dandelion, and eating loads of cruciferous vegetables, and
• Limiting exposure to xenoestrogens by:
• Investing in a glass or steel water bottle
• Using a non-plastic, reusable mug for coffee and tea
• If you must buy packaged food, choosing foods in glass containers
• Never heating food in plastic
• Using BPA-free canned goods
• Buying organic, especially when it comes to meat
• Swapping out your beauty and cleaning products 

TOO LITTLE ESTROGEN

As previously stated, estrogen is responsible for the health of many critical organs like the heart, bones and reproductive organs. So, although too much estrogen can be problematic, we don’t want too low levels of estrogen either. With age, estrogen levels will naturally start to decline until menopause, but younger women can experience low levels of estrogen as well, and these women are at risk because they don’t benefit from the protective effects of estrogen.

Some reasons for too little estrogen in younger women include excessive exercise, eating disorders, pituitary gland dysfunction, premature ovarian failure (aka early menopause), and some chronic health conditions. 

SYMPTOMS OF TOO LITTLE ESTROGEN INCLUDE:

• Irregular periods, or missed periods all together
• Decreased sex drive
• Brain fog or poor memory
• Painful sex due to vaginal dryness
• Hot flashes
• Depression
• Fatigue
• Fine lines and wrinkles

If you think that you may fall into this category of having too little estrogen, I recommend seeing your healthcare provider. If left untreated, low estrogen can lead to more serious concerns like osteoporosis, heart disease, and infertility.

 

PROGESTERONE

Progesterone is another key female hormone. It is made in one of the ovaries in the second half of the menstrual cycle, after ovulation and is responsible for maintaining a pregnancy, if a pregnancy occurs. If there is no pregnancy, progesterone levels drop and this is what brings on the period each cycle. If a woman doesn’t ovulate,  progesterone will not be produced and this can be a common reason for low progesterone levels.

The most common cause of absent ovulation is PCOS, but this can also be due to extreme stress, undereating, over-exercising, thyroid conditions, high prolactin, obesity, low body weight, or perimenopause. It is not uncommon to see low levels of progesterone in a clinical setting, however, excess progesterone levels are very rarely seen. High progesterone levels are usually only associated with pregnancy, when supplementing with progesterone, and in the rare condition known as congenital adrenal hyperplasia.

When progesterone is low, it produces a relative estrogen dominance, because the progesterone is not high enough to balance the estrogen. This explains why the symptoms of low progesterone are similar to symptoms of too much estrogen. Furthermore, this is why hormone testing is essential and I always encourage women to have a proper assessment done by a healthcare professional to ensure the right treatment is provided.

SYMPTOMS OF TOO LITTLE PROGESTERONE INCLUDE:

• Heavy or irregular cycles
• Fibrocystic breasts
• Mid-cycle spotting
• Anxiety
• Sleep disorders
• Irritability
• Menstrual cramps
• Shorter cycles

It is really important to determine why a woman has low progesterone levels to begin with and to understand if she is ovulating. This will dictate what type of treatment to use, since treatment for PCOS is different than treatment for low progesterone due to extreme stress, for example.

Some treatment considerations for low progesterone levels include:

• Ensuring adequate caloric intake – remember fat is essential for hormone production
• Supplementing with necessary nutrients – zinc, selenium and vitamin D have all been associated with progesterone production
• Use of botanicals like chaste tree can help promote ovulation and thus, boost progesterone
• Reducing stress is essential, and sometimes bioidentical progesterone therapy is required

 

TESTOSTERONE

Testosterone, although commonly referred to as a male sex hormone, is also present in women (at smaller amounts, of course) and is an essential hormone for female sexual health. Most women cringe when they hear the word testosterone because they associate it with acne outbreaks and hair in all the wrong places, however, testosterone enhances cognitive performance, improves musculoskeletal health,  boosts sex drive and plays a role in general motivation. High levels of testosterone in women are commonly due to PCOS. By addressing the underlying cause of PCOS and correcting ovulation, the amount of testosterone will inherently decrease, improving estrogen and progesterone levels as well, all of which will help with the symptoms of high testosterone.

SYMPTOMS OF TOO MUCH TESTOSTERONE INCLUDE:

• Acne and or/ oily skin
• Hair loss on the head, aka male pattern baldness
• Excess body hair on the face, abdomen, and chest
• Infertility
• Increased body odour
• Sleep issues
• Aggression and moodiness
• Irregular cycles, usually longer cycles

 

At the same time as the underlying cause is being treated, supplements can be used to reduce testosterone to improve symptoms like acne and abnormal hair growth. Some of these supplements include:

• Diindolylmethane (DIM) found in cruciferous veggies like kale, broccoli, and cauliflower can prevent testosterone production. While eating cruciferous vegetables is helpful, to reach a therapeutic dose it should be used in supplemental form

• Zinc is a natural testosterone blocker and is essential for skin health, so it is very useful in treating acne caused by excess testosterone

• Also, botanicals like White Peony and Licorice are shown to be effective in lowering testosterone levels in the blood

On the flip side, too little testosterone can also lead to some undesirable symptoms. Like estrogen, testosterone declines naturally with age, but in a younger woman low levels of testosterone may indicate a problem with the ovaries or adrenal glands, as this is where testosterone is made.

SYMPTOMS OF TOO LITTLE TESTOSTERONE INCLUDE:

• Fatigue
• Depression
• Lack of sex drive
• Vaginal dryness
• Infertility
• Loss of periods
• Decreased muscle mass

I advise every woman reading this to get a thorough investigation before self-prescribing any of the above treatments. I say this because as you can see, there are many overlapping symptoms associated with different hormonal imbalances. This is why I always say “test, don’t guess” since only the appropriate treatment will improve your symptoms for good. If you think you have a hormone imbalance, check-out this article to get a better understanding of the common causes underlying your issues.

Optimal hormone balance is critical to overall health. Estrogen, progesterone, and testosterone play a much bigger role than just regulating the menstrual cycle. If you are on a journey to finding your best health, identifying hormone imbalances is key. And you’re in luck because there are so many treatments options available to achieving balanced hormones.

To happy hormones,
Dr. Bronwyn

Image by @marcymedia